title: Citrullinemia stimulation test in the evaluation of the intestinal function.
abstract: BACKGROUND
  Citrullinemia is been reported as a quantitative parameter of the enterocyte mass and function.
  
  
  OBJECTIVE
  The objective of this research is to analyse the value of fasting and stimulated citrullinemias in the intestinal function evaluation.
  
  
  METHODS
  A case-control study was undertaken, including 11 patients with short bowel syndrome, 13 patients submitted to malabsorptive bariatric surgery and 11 healthy controls. Plasma levels of amino acids were determined, before and after a stimulation test with oral Lglutamine, by ion exchange chromatography.
  
  
  RESULTS
  Citrullinemia was inferior in short bowel patients (28,6 ± 11,3 versus 35,5 ± 11 in operated obese versus 32,2 ± 6,6 μmol/L in controls; n.s.) and lower than 25,5 μmol/L in 54,5% of them (versus 16,7%; p = 0,041; accuracy = 74%; odds ratio = 3, 95%CI 1,2-7,6). ΔCitrullinemia80 (relative variation of citrullinemia at the 80th minute of test) was lower in short bowel patients; its diagnostic accuracy was similar to baseline citrullinemia and also not significant. ΔCitrullinemia80 revealed a high predictive capacity of a short bowel inferior or equal to 50 cm (auR.O.C. = 82,3%; 95%CI 61,7-102,8; p = 0,038).
  
  
  CONCLUSIONS
  In short bowel syndrome context, citrullinemia stimulation test with oral L-glutamine is feasible and it may improve the predictive capacity of severity. Further investigation is required to determine its clinical relevance and applicability.
authors.affiliation: Coimbra University Medical School and IIIrd Surgical, Department of Coimbra University Hospitals, Coimbra, Portugal. beatrizpcosta@iol.pt
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pinto Costa
authors.forename: Marco
authors.initials: M
authors.lastname: Serôdio
authors.forename: Marta
authors.initials: M
authors.lastname: Simões
authors.forename: Carla
authors.initials: C
authors.lastname: Veríssimo
authors.forename: F
authors.initials: F
authors.lastname: Castro Sousa
authors.forename: Manuela
authors.initials: M
authors.lastname: Grazina
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050110:Bariatric Surgery; D001823:Body Composition / Q000502:physiology; D016022:Case-Control Studies; D002956:Citrulline / Q000097:blood*; D020159:Citrullinemia / Q000175:diagnosis*; D017097:Electric Impedance; D005215:Fasting; D005260:Female; D018698:Glutamic Acid / Q000494:pharmacology; D006801:Humans; D007422:Intestines / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009765:Obesity / Q000378:metabolism; D016017:Odds Ratio; D012778:Short Bowel Syndrome / Q000378:metabolism
chemical_list: D002956:Citrulline; D018698:Glutamic Acid